Feasibility of Proton Beam Therapy for Ocular Melanoma Using a Novel 3D Treatment Planning Technique.

Purpose: We evaluated sparing of normal structures using 3-dimensional (3D) treatment planning for proton therapy of ocular melanomas.

Methods And Materials: We evaluated 26 consecutive patients with choroidal melanomas on a prospective registry. Ophthalmologic work-up included fundoscopic photographs, fluorescein angiography, ultrasonographic evaluation of tumor dimensions, and magnetic resonance imaging of orbits.

Outer retinal structure after closed-globe blunt ocular trauma.

Purpose: To evaluate outer retinal structural abnormalities in patients with visual deficits after closed-globe blunt ocular trauma.

Methods: Nine subjects with visual complaints after closed-globe blunt ocular trauma were examined between 1 month after trauma and 6 years after trauma. Spectral domain optical coherence tomography was used to assess the outer retinal architecture, whereas adaptive optics scanning light ophthalmoscopy was used to analyze the photoreceptor mosaic integrity.

Reactivation of retinopathy of prematurity after bevacizumab injection.

Objective: To report late reactivation and progression of retinopathy of prematurity (ROP) after intravitreal bevacizumab monotherapy.

Methods: Retrospective review of 9 patients (17 eyes) with recurrence of ROP after initial treatment with intravitreal bevacizumab monotherapy. Data collected included (1) location and stage of ROP activity, (2) number and timing of treatments, and (3) structural outcomes.

Amiodarone-associated optic neuropathy: a critical review.

Although amiodarone is the most commonly prescribed anti-arrhythmic drug, its use is limited by serious toxicities, including optic neuropathy. Current reports of amiodarone-associated optic neuropathy identified from the Food and Drug Administration's Adverse Event Reporting System and published case reports were reviewed. A total of 296 reports were identified: 214 from the Adverse Event Reporting System, 59 from published case reports, and 23 from adverse events reports for patients enrolled in clinical trials.

Transconjunctival 20-gauge vitrectomy outcomes.

Background And Objective: To investigate the short-term complication profile of the transconjunctival 20-gauge trocar-cannula (20g-TCV) system.

Patients And Methods: Patients who underwent primary 20g-TCV without history of prior vitrectomy were included. The primary outcome was incidence of short-term hypotony.

Mucormycosis infection of the lacrimal sac.

Biopsy of the lacrimal sac for patients with primary acquired nasolacrimal duct obstruction has been a topic of debate for many years. The authors present a case of a 72-year-old immunocompetent woman with a 2-month history of epiphora secondary to nasolacrimal duct obstruction. During an uneventful dacryorhinocystostomy, a routine lacrimal sac biopsy was performed and revealed mucormycosis.

Intravitreal bevacizumab for neovascular glaucoma.

Purpose: To report 6-month and 1 year outcomes of eyes treated for neovascular glaucoma (NVG) with intravitreal bevacizumab injection and panretinal laser (PRP) compared to those receiving PRP alone.

Design: retrospective, consecutive case series.

Methods: Charts of patients with NVG from retinal ischemia and at least 6 months of follow-up were reviewed.

Septo-optic dysplasia with bilateral congenital corneal anesthesia.

Septo-optic dysplasia, or de Morsier syndrome, is characterized by optic nerve hypoplasia with an absent septum pellucidum and/or pituitary abnormalities. Congenital corneal anesthesia is a rare disorder that has been associated with many neurological disorders. Here we present a patient with both conditions who was successfully treated with permanent lateral tarsorrhaphy and aggressive lubrication.

Treating uveitis-associated hypotony with pars plana vitrectomy and silicone oil injection.

Purpose: The purpose of this study was to determine the effect on intraocular pressure (IOP) and visual acuity of treating uveitis-related hypotony in patients with vitrectomy and intravitreal silicone oil injection.

Methods: Patients who underwent pars plana vitrectomy and silicone oil injection for uveitis-associated hypotony treatment were identified retrospectively. The primary outcome was maintaining an IOP of > or =5 mmHg.

MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging.

Objective: Our aims were to describe the role of diffusion-weighted imaging (DWI) in detecting abscess as a complication of orbital cellulitis and to assess whether abscess can be diagnosed with a combination of conventional unenhanced sequences and whole-brain DWI with parallel acquisition. Nine cases of orbital cellulitis imaged with MRI were retrospectively reviewed, including six cases with pyogenic abscess.

Conclusion: In this preliminary study, DWI improved diagnostic confidence in nearly all cases of orbital abscess when used in conjunction with contrast-enhanced imaging.

Flecked-retina syndromes.

A number of retinal disorders may present with fleck-like lesions in the retina. We describe the case of a 13-year-old girl who presented with a complaint of decreased vision and prior diagnosis of "fleck-retina." Further examination revealed that the patient had an autosomal recessive disorder associated with systemic manifestations.

Objective measurement of periocular pigmentation.

Purpose: To evaluate the Minolta CR-400 chromameter in objectively measuring periocular/facial pigmentation in subjects of different ethnicities.

Methods: The CR-400 was used to obtain skin color measurements from 75 African-American, Caucasian and Hispanic subjects in 16 facial and periocular locations. Comparisons between ethnic and Fitzpatrick groups and instrument reliability were analyzed.

Corneal pathology in microphthalmia with linear skin defects syndrome.

Purpose: To describe the histopathology of the cornea in microphthalmia with linear streaks (MLS) syndrome.

Methods: Two patients with MLS syndrome underwent penetrating keratoplasty. This study describes the histopathology and investigates immunophenotype of the corneal extracellular matrix by using keratan sulfate and collagen type III antibodies.

Histologic findings after surgical excision of optic nerve head drusen.

Purpose: To report the histopathologic findings of a case of bilateral massive optic nerve head (ONH) drusen.

Methods: A 59-year-old man presented with bilateral massive ONH drusen and secondary compromise of the retinal vasculature leading to vision of counting fingers at 1 ft in the left eye and 20/30 in the right eye. The inferior one half of the left ONH druse was excised resulting in no light perception vision postoperatively.

Deep lamellar endothelial keratoplasty: histopathology of complications in initial cases.

Purpose: To report complications encountered after 2 initial cases of deep lamellar endothelial keratoplasty.

Methods: Review of clinical findings of 2 initial cases in which intraoperative and postoperative complications were encountered. Corneal buttons from the 2 cases were evaluated by light microscopy and transmission electron microscopy.

The effect of temperature on the antimicrobial activity of Optisol-GS.

Purpose: To determine the survival of different bacteria inoculated in Optisol-GS at refrigerated storage temperature (6 degrees C) and after subsequent warming to room temperature (19-22 degrees C).

Methods: Staphylococcus aureus, Enterococcus faecium, Streptococcus pneumoniae, and Pseudomonas aeruginosa were chosen from stock clinical isolates for inclusion in the study. The first group consisted of 12 Optisol-GS vials.

Bimatoprost-induced periocular skin hyperpigmentation: histopathological study.

Objective: To investigate light microscopic and ultrastructural changes in bimatoprost-induced skin hyperpigmentation.

Methods: Eyelid biopsy specimens from bimatoprost-treated patients and matched controls were examined by light microscopy and transmission electron microscopy. Using an image analyzer, melanin granules were counted on Fontana-Masson-stained sections, and melanosomes were counted on electron micrographs.

Orbital schwannoma and neurofibroma: role of imaging.

Schwannomas are well-circumscribed ovoid masses that most commonly present in the superior orbit. Although it may be difficult to differentiate these benign masses from other orbital tumors on radiologic imaging, the CT and, in particular, the MR imaging characteristics can sometimes point to the diagnosis of a nerve sheath tumor. A definitive diagnosis can be made through correlation with histopathologic findings, however.

Medulloepithelioma of the ciliary body and optic nerve: clinicopathologic, CT, and MR imaging features.

The definitive diagnosis of medulloepitheliomas of the ciliary body and optic nerve is made by histopathologic examination. Familiarity with rare tumors aids clinicians in accurately diagnosing this rare neoplasm. CT and MR imaging findings can be helpful, especially if the mass is confined in an area of the ciliary body without involvement of the retina.